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Volunteer Registration


 

VOLUNTEER CONSENT FORM FOR THE BP MS 150

Please Note: If you are 17 years and younger, you must print this version of the agreement, have your legal guardian sign it, and submit a hardcopy to National MS Society. You may bring the printed copy of this form with a parent/guardian signature the day of the event.

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Date of Birth:

 

 

 

 

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 VOLUNTEER CONSENT FORM FOR THE BP MS 150 - WAIVER INFORMATION

*ATTENTION - UNDERAGE WAIVER AND RELEASE FORM - Please Note: If you are 17 years and younger, you must print this version of the agreement, have your legal guardian sign it and submit a hardcopy to National MS Society before you can participate in this event.

Please take a moment to read the following waiver and release agreement.

Printable Version

EMERGENCY MEDICAL TREATMENT AUTHORIZATION: I hereby consent to and permit emergency treatment in the event of injury or illness while participating in the event.

MEDIA RELEASE: I hereby give permission to the National Multiple Sclerosis Society and South Central to use my name, and any photograph, likeness or image taken of me during the event in any promotional materials, publication or via the website.

CONFIDENTIALITY AGREEMENT: To the degree that I may be given access to the identity and details of persons with multiple scleroiss and their families, I will safeguard such information in strict confidence.

ALCOHOL AND DRUG USE: National Multiple Sclerosis Society policy prohibits the use of alcohol or other unauthorized or illegal drugs during working hours by its volunteers. No volunteer who has been drinking, or is under the influence of unauthorized drugs, will be permitted to work in offices or at Society-sponsored events.

CODE OF CONDUCT: I understand and have agreed to participate in the South Central event/program as a volunteer and have read and understand my responsibilities to be performed. Based on the Society’s “code of conduct”, I also understand that as a representative of the National MS Society, I must always conduct myself in a fashion that does not jeopardize the image of the Society.

APPROPRIATE BEHAVIOR: It is my further understanding that National MS Society reserves the right to refuse or
dismiss anyone that may cause any disturbance or hindrance in any manner that could jeopardize the safety of oneself or others.

TRANSPORTATION: It will be my sole responsibility to obtain the necessary mode of transportation to perform these responsibilities. If for whatever reason I am unable to perform as agreed, I will advise the South Central, event
coordinator immediately.

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Question - Required - By checking the box below, you are confirming with the consent form outline above.

 

 VOLUNTEER CONSENT FORM FOR THE BP MS 150 - CODE OF CONDUCT

This Code is intended to help members of the National and chapter boards, other leadership volunteers and staff avoid situations that could compromise the integrity and independence of the Society’s decision-making processes, or compromise the Society’s reputation or public confidence in the Society. It is presumed that this Code will be supplemented by good judgment since it cannot contemplate all possible situations of actual or potential conflict of interest. Situations in which personal interests conflict or appear to conflict with the interest of the Society must be avoided. The appearance of a conflict can be just as damaging to the reputation of the Society as an actual conflict.

All members of the National and chapter boards, leadership volunteers and staff shall:

  1. Authorize the use of the name, emblem, endorsement, services, or property of the National Multiple Sclerosis Society only to advance the mission of the Society and in conformance with Society policy.

  2. Seek financial or other resources in the name of the Society, in the best interests of the Society. No trustee, leadership volunteer, or staff member shall accept personal gifts or gratuities (other than very small, inconsequential benefits) from a supplier of goods, equipment or services.

  3. Not knowingly take any action or make any statement intended to influence the conduct of the Society in such a way as to confer any financial benefit on such person or any corporation or entity in which the individual has an interest or affiliation.

    Trustees, leadership volunteers and staff shall scrupulously avoid any conflict between their own respective personal, professional or business interests and the interests of the Society. Among other circumstances, potential conflicts of interest may exist whenever a trustee, a leadership volunteer or staff member, or an employee of such person or a member of his or her family has an interest in a business transaction or proposed transaction involving the Society.

  4. Use association with the Society in public events only to advance the mission of the Society. No trustee, leadership volunteer or staff member shall publicly utilize any Society affiliation in connection with the promotion of partisan politics, religious matters, or positions on any issue not in conformity with the position of the Society.

  5. Maintain the confidentiality and privacy standards of the Society. No trustee, leadership volunteer or staff member may disclose or reveal or use confidential or proprietary information of the Society or its clients without express authorization.

  6. Not use information regarding or acquired as a result of Society relationships with corporations, or government agencies, or their employees or other sources to buy, sell, or otherwise make transactions of stock, securities or other assets of corporations, their subsidiaries, parents, or competitors or otherwise act for personal benefit or gain themselves or their relatives, friends or business associates.

  7. Periodically affirm in writing upon request of the President of the Society or its chapters that he or she has received, read and understands and agrees to be bound by this Code of Conduct.

    Members of scientific and medical professional advisory bodies must avoid situations of possible conflict of interest, or the appearance of a conflict of interest, in the recommendation of grants to their institutions. The member of any institution by which a Society grant is to be considered shall absent himself or herself from the room during the course of discussion and the vote.

    In the event that a trustee leadership volunteer’s or staff member’s obligation to operate in the best interests of the Society might conflict with his or her personal interests, or with the interests of any organization in which they have an interest, financial or otherwise, or with which they are affiliated, they shall disclose such conflict and any and all relevant information as soon as they become aware of it, shall absent themselves from any relevant deliberations, and shall refrain from participating in decision making in connection with the matter.

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Question - Required - By checking the box below, you are agreeing to conform with the National Multiple Sclerosis Society Code of Conduct.

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